21. Level 1: Direct Quantitative Data on Functional Systems Facilitation

21. Level 1: Direct Quantitative Data on Functional Systems Facilitation

At this level we have three independent blocks of data, each obtained with validated international scales. I will take them one at a time.

The 2014 Study: Shamenkov, Ulyanin, Sudakov

In 2014, together with A. Yu. Ulyanin and Academician K. V. Sudakov, I carried out the first formal study of the approach’s effectiveness. The work was titled “The Result of the Practical Application of an Innovative Human Health Management System Developed on the Basis of Academician P. K. Anokhin’s Theory of Functional Systems,” and it was published in the proceedings of the scientific conference “Rehabilitation and Prevention–2014” at the I. M. Sechenov First Moscow State Medical University¹.

Design. The “Synchronization 1.0” training, 30 days, in an online format that combined: — daily group practices of silence in a webinar room; — a closed community on a social network for sharing experiences; — 8 methodological webinars (twice a week) analyzing the practices and answering questions; — regular exercises following the program.

Sample. 163 people took part; 55 completed full measurements (before and after). Mean age — 39 years 8 months; 60% women.

Measurement instrument. The WHOQOL-100 questionnaire — a validated World Health Organization instrument for assessing quality of life. 100 questions, 6 domains: physical, psychological, level of independence, social relationships, the environment, and the spiritual domain, plus an overall score. This is the full (not the abbreviated) version of the instrument, which makes it especially sensitive to multidimensional change.

Results for the whole group (n = 55):

All six domains improved over 30 days. That alone is worth noting. But the most interesting finding emerged once the sample was split into two subgroups by initial quality-of-life level.

Group No. 1 — initially low quality of life (below the group average, n = 26):

Group No. 2 — initially high quality of life (above average, n = 29):

The main methodological takeaway of this study: the largest gains appeared in the group of people with an initially low level of quality of life — precisely where ordinary approaches often stall, because the person has already exhausted the “available” forms of help and gotten no result. This is encouraging; but in an uncontrolled design it cannot yet be separated from regression to the mean. A 27% gain in the physical domain and a 25% gain in the psychological domain over 30 days is a change of a magnitude sometimes reported for intensive treatments — though, without a control group or a direct comparison, this is suggestive rather than evidence of equivalence to pharmacotherapy, and it came without reported side effects.

Even this early work yielded reliable preliminary data, showing that the approach is not only conceptually well-grounded but does genuine work in practice. It was, however, part of a broader program that, in 2018, crystallized into a distinct method with its own name — Functional Systems Facilitation.

Merkulieva’s 2020 Dissertation Study

The next substantial block of data is the candidate-of-sciences (PhD-equivalent) dissertation of T. A. Merkulieva, defended in 2020. The work is devoted entirely to the Functional Systems Facilitation method — to its effectiveness against burnout and to the dynamics of participants’ quality of life across the Intensive programs.

Merkulieva’s key publications on this material²:

• Merkulieva T. A. The Dynamics of Self-Attitude in Participants of a Program for Reducing Emotional Burnout // Bulletin of Integrative Psychology. 2020. No. 21. Pp. 219–222 (co-authored with me and Prof. V. V. Kozlov).

• Merkulieva T. A. A Study of Quality of Life Before and After the “Open Dialogue Intensive” Program // The Human Factor: Social Psychologist. 2020. No. 2(40). Pp. 222–227.

• Merkulieva T. A. The Application of the “Open Dialogue” Method for the Prevention and Correction of Burnout States // The Psychology of the 21st Century / ed. V. V. Kozlov. Yaroslavl, 2020. Pp. 253–256.

The dissertation was defended at the Russian Presidential Academy of National Economy and Public Administration, Department of Psychology, and became the first defended dissertation built entirely on material from the Functional Systems Facilitation method. It documented significant positive dynamics in measures of self-attitude, quality of life, and the reduction of burnout symptoms among participants of the Intensive program. Below are the main parameters of the study and its numerical results.

Design. A pre-post study of participants in the week-long FSF Intensive program, conducted online (using computer-mediated communication) over the period from April to September 2020.

Sample. 27 adult Russian-speaking participants with a request for change, development, problem-solving, or the prevention and correction of burnout: 21 women and 6 men; mean age — 38 years; 61% married or in family relationships; 84% with higher education. Participants learned about the program through online resources.

Measurement instrument. N. E. Vodopyanova’s “Assessment of the Level of Satisfaction with Quality of Life” questionnaire — a validated instrument widely used in Russian occupational psychology and in studies of professional burnout. The questionnaire measures subjective satisfaction across 5 domains of life activity (work, personal achievements, health, communication with loved ones, the support domain) and 4 personality qualities (optimism, self-control, tension, negative emotions), and it computes an overall life-satisfaction index. Measurements were taken at the start and at the end of the program.

Statistical method. The Wilcoxon signed-rank test for comparing dependent samples (before-and-after measurements in the same participants).

Pre-post results (n = 27):

¹ In N. E. Vodopyanova’s questionnaire, the “tension” scale reflects a subjective assessment of one’s ability to cope with psychological strain: a rise in the score means a decrease in experienced tension and a growing sense of coping. ² Negative emotions is the only scale in the questionnaire on which a higher score means a worse state; a decrease in it is positive dynamics. ³ Dashes (—) indicate that the publications report only percentage changes, without absolute before/after values.

Statistical significance. The Wilcoxon signed-rank test for the overall quality-of-life satisfaction index showed a high level of significance (α = 0.01). The “typical” shift toward increase reliably predominated in intensity: of the 27 participants, 19 showed a substantial positive shift, 4 essentially none, and 4 a slight negative shift. On the personal achievements, tension, and self-control scales — those most closely tied to self-attitude — the positive shift also reliably predominated at α = 0.01.

Conceptual conclusion: the dynamics of self-attitude. In the joint publication with V. V. Kozlov, Merkulieva and I argue separately why the personal achievements, self-control, and tension measures in Vodopyanova’s questionnaire directly reflect self-attitude: the items on these scales concern self-respect, life values and principles, the sense of being understood and respected in a professional setting, self-possession, dependability, the ability to organize one’s time, and the number and severity of life crises. A reliable positive shift on all three scales indicates that, over a single week of intensive practice in an FSF group, participants undergo a marked restructuring in how they relate to themselves. This is consistent with A. Längle’s idea that burnout is bound up with the loss of one’s relationship with oneself: when a person’s contact with their own feelings, values, and goals is restored, quality of life often improves as well.

A limitation and its significance. Merkulieva’s study has no control group — it is a typical pre-post design, which does not allow one to subtract out the effect of nonspecific factors (the expectation effect, regression to the mean, the Hawthorne effect). That is precisely why it is embedded in a multilevel system of evidence: the direct data from 2014 (n = 55, 30 days, WHOQOL-100), the platform’s own data from 2024 (n = 54, WHOQOL + GAD-7 + PHQ-9), the body of qualitative data from the Intensives, and, above all, the planned, registered RCT within my doctoral program at Nova University Lisbon (NCT07276451), which will for the first time introduce full control of conditions. At the same time, the fact that the direction and order of magnitude of Merkulieva’s effects reproduce those obtained in 2014 and 2024 — on independent samples and with different instruments — argues that this is not random noise but a stable effect.

The Opendialogue.space Platform: 2024 Data

The third and most recent block of direct quantitative data was presented in my program presentation at the 14th Doctoral Program in Public Health (Lisbon, November 2024) — work within my current PhD research at Nova University Lisbon³.

Design. A pre-post study of participants in FSF Intensives on the Opendialogue.space platform.

Sample. n = 54 participants in intensive courses.

Measurement instruments. Validated international scales: — WHOQOL for assessing quality of life across various domains; — GAD-7 for anxiety; — PHQ-9 for depression; — stress and exhaustion scales.

Results:

Two figures deserve special attention here: the 21% reduction in anxiety and the 12.6% reduction in depressive symptoms in people who completed the Intensive. The anxiety reduction in particular is substantial; it falls in the range of improvement reported for effective psychological interventions. We did not, however, compute a standardized effect size for this sample, so the comparison is approximate. And because this is an uncontrolled pre/post change, it cannot be directly equated with controlled pharmacotherapy trials — though it is worth noting that no adverse effects were reported in this sample.

It is also worth noting that these effects were obtained over the course of a single Intensive (5 group sessions plus an integration meeting), not over many months of work. This points to a highly concentrated effect in the intensive format.

A Summary Picture of Level One

Gathering the data from three independent studies — conducted ten years apart, on different samples, by different teams — the picture looks like this:

• 2014 (n = 55, 30-day online program, WHOQOL-100): a quality-of-life gain of +12.6% for the whole group; +18.7% in people with an initially low level; up to +27% in the physical domain in the neediest subgroup.

• 2020 (Merkulieva, dissertation, n = 27, N. E. Vodopyanova’s questionnaire): an overall quality-of-life satisfaction index up by +10% (from 25.5 to 28.1; α = 0.01); gains across all domains — personal achievements +14%, communication with loved ones +13%, the support domain +12%, work +10%, health +3%; and across personality qualities — self-control +10%, tension +14%, negative emotions −10%.

• 2024 (n = 54, Intensive, WHOQOL + GAD-7 + PHQ-9): all quality-of-life measures rose at significance levels from p < 0.05 to p < 0.001; anxiety fell by 21%, depression by 12.6%.

The consistent direction across three independent samples argues against random fluctuation. Without controls, however, it cannot yet attribute the effect specifically to the method rather than to nonspecific factors — which is exactly what the planned RCT is designed to test.